| NPI | 1881248292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9558) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 1161725) |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2025-03-05 |